Objective Toobservetheclinicalsignificanceofcerebrovascularhemodynamicindex (CVHI)inthepatientswithsilentcerebralinfarction.Methods Atotalof180patientsperformed cerebrovascular hemodynamics with ultrasound and head MRI examinations were enrolled retrospectively. They were divided into three groups:60 patients with silent cerebral infraction (SCI)were used as a SCI group,60 age-,sex- and previous medical history-matched high risk patients with cerebrovascular disease were used as a cerebrovascular disease risk factor (CV-HRF)group,and 60 healthy subjects were used as a normal control group over the same period. Cerebrovascular function detector was used to collect CVHI at the bilateral carotid arteries. The CVHI features of the 3 groups were analyzed and compared. Results Comparedwiththecontrolgroup,thereweresignificantchangesinvariousindexesofcerebral vascular hemodynamics in the SCI group and the CV-HRF group. The indexes of reflecting the cerebral blood supply state included significantly decreased mean blood flow,mean flow velocity,maximum flow velocity,and minimum flow velocity (P<0. 05);the indexes reflecting vascular elastic properties and resistance status included the increased pulse wave velocity,characteristic impedance,peripheral resistance,and dynamic resistance (P<0. 05);the indexes reflecting cerebral microcirculation included significantly increased critical pressure and decreased differential pressure (P<0. 05);the total score of cerebrovascular function was also decreased significantly,they were 44 ± 9,51 ± 5,and 85 ± 7,respectively (P<0. 05);there were significance differences in the distribution of total score amongthe3groups(P<0.05).Conclusion Thehigh-riskpatientswithsilentcerebralinfarction and cerebrovascular disease have the CVHI changes. The total integrated value of cerebrovascular function declined,and the former is more obvious.

Objective To investigate the immune disorder in elderly patients with severe ischemic stroke and to explore whether a new type of diabetes-specific enteral nutrition formula can regulate the immune function of these patients.Methods In the randomized controlled prospective study,90 patients aged 60-80 years with acute ischemic stroke and NIHSS score more than 10 and dysphagia were randomized to two groups:receiving a new type(Group A) of,versus traditional(Group B) diabetes-specific enteral nutrition.30 Patients aged 60-80 years with acute ischemic stroke and NIHSS score ≥10 without dysphagia were enrolled as control(Group C).The immune function was observed,and the nutritional status and immunological function were compared between two different enteral nutrition groups at 7 days of treatment.Results After 7 day follow-up,the serum lipid stats significantly ameliorated in group A.An obvious suppression of immune state was observed in severe acute ischemic patients at onset of 7 days.At day 7 of treatment,the percentage of CD3+ T cells in group A was(69.25±9.93)％ after treatment vs.(63.36±7.79)％ at baseline(P＜0.001),and CD3 +CD4+T cells was(45.79±9.47)％ after treatment vs.(36.12±9.15)％ at baseline(P＜0.001),as well as CD4+/CD8+ cells were(2.27±1.40)％ after treatment vs.(1.70±0.82)％ at baseline(P=0.001).At 7 days of treatment,the percentage of CD3+ T cells was higher in group A (69.25 ±9.93) ％ than in group B(63.07± 9.47) ％ (P＜0.001),and the percentage of CD3 + CD4 cells was higher in group A(45.79 ± 9.47) ％ than in group B(41.32 ± 8.89) ％ (P=0.024).Conclusions Enteral nutrition preparations can provide sufficient energy support in the acute ischemic stroke.Immunosuppressive state exists in patients with acute phase of severe ischemic stroke.The new type of diabetic enteral nutrition formula can significantly improve immunosuppressive state in patients with acute severe stroke.

Current therapies for chronic hepatitis caused by hepatitis C virus (HCV) are limited . DNA vaccination may constitute a new immunotherapeutic strategy for various hepatitis virus infections by promoting specific cellular and humoral immunity. In this review we present the advances in choice of antigen gene, vaccine adjuvants and the methods of intracellular delivery, unresolved questions and therapeutic potential of HCV DNA vaccine.

OBJECTIVE:To observe therapeutic efficacy of Sanjin granules in the treatment of residual stones after extracorpo-real shock wave lithotripsy(ESWL). METHODS:72 patients with residual stones after ESWL were selected and randomly divided into group A and B with 36 cases in each. Patients in group A were given Sanjin granules with warm water,2 times/d,20g/time;B group were treated with conventional therapy as drinking more water combined with jumping movement. Therapeutic efficacies of two groups were observed after 4 and 8 weeks of treatment. RESULTS:After 4 weeks treatment,the total effective rate was 33.33% in group A and 13.89% in group B,there was statistically significant difference(P<0.05);After 8 weeks treatment,the total effective rate was 63.89% in group A and 19.44% in group B,there was statistically significant difference(P<0.05). CON-CLUSIONS:Sanjin granules can pass the residual gallstones after ESWL effectively,showing a significant therapeutic efficacy.

Objective:To compare the oncology effect and risk between hepatopplenectomy and conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, so as to provide guidance for clinical application.Methods:One hundred and eighteen patients with hepatic carcinoma with hypersplenism in the Private hospitals of Zhejiang Province Yiwu were studied retrospectively. Patients were divided into 2 groups according to different operation methods: combined hepatosplenectomy group and conventional hepatectomy group with 59 cases in each group. Blood routine, liver function, complication and tumor effect (local recurrence, distant metastasis and 1, 3, 5 years survival rate) was compared between two group.Results:There was no significant difference in operation time, intraoperative blood loss and hospitalization time between the two groups ( P>0.05). Compared with that of the control group, the clinical total effective rate of the combined group was significantly increased: 94.92% (56/59) vs. 79.66% (47/59), P<0.05; there was no significant difference in the incidence of complications between the two groups ( P>0.05); the two groups were followed up to August 1, 2019. The median survival time of the two groups was significantly higher than that of the open group (29 months vs 22 months) ( P<0.05); the local recurrence rate, distant metastasis rate, 1, 3 and 5-year survival rate between the two groups were statistically significant ( P<0.05). The platelet and white blood cells in the combined group were significantly higher than those in the control group after 7 days′ treatment: (264.48 ± 75.37) × 10 9/L vs. (153.53 ± 42.11) × 10 9/L, (7.86 ± 1.43) × 10 9/L vs. (3.48 ± 1.32) × 10 9/L, P<0.05. Compared with that of the control group, alanine aminotransferase and aspartate aminotransferase were significantly decreased: (49.42 ± 31.88) U/L vs. (84.22 ± 43.95) U/L, (36.50 ± 21.50) U/L vs. (49.98 ± 35.63) U/L, P<0.05. Conclusions:Compared with conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, combined hepatosplenectomy can effectively promote the increase of peripheral blood PLT and WBC and the recovery of liver function without increasing the risk of surgery, and the long-term follow-up results are more satisfactory, which has high clinical application value.

Objective_To explore the influence and mechanism of IL-31 on the expression of VEGF, EGF and EG-FR in 16HBE cells.Methods_16HBE cells were cultured and treated with IL-31 with or without SB203580 or SP600125, real-time PCR and Western blot were applied to determine the mRNA and protein expression of VEGF, EGF and EGFR respectively.Meanwhile, Western blot was used to examine the changes of P38 MAPK and JNK signaling pathways.Results_Compared with control group, the mRNA expression of VEGF, EGF and EGFR was increased markedly under the stimulation of IL-31 ( P<0.01 ) , the expression of p-P38 MAPK and p-JNK signifi-cantly increased ( P<0.01) .Compared with IL-31 group, the expression of p-P38 MAPK significantly decreased in IL-31 combined with SB203580 or SB203580 group ( P <0.01 ) , while the expression of p-JNK markedly decreased in IL-31 combined with SP600125 or SP600125 group( P<0.01) .Compared with IL-31 group, the expression of VEGF was significantly decreased in IL-31 combined with SB203580 or SP600125 group ( P <0.01 ) , while the expression of EGF and EGFR was markedly declined in IL-31 combined with SB203580 group ( P<0.01 ) .Conclusions_IL-31 may up-regulate the expression of VEGF through activating P38 MAPK and JNK signaling pathways and up-regulate the expression of EGF and EGFR through activating P38 MAPK signaling path-way in16 HBE cells.

Objective To investigate the characteristics of HBsAg and HBcAg in combination pulsed monocyte-derived DCs(MoDC) derived from patients with HBV-associated hepatocellular carcinoma(HCC).Methods MoDCs were generated from 20 HBV-associated HCC patients,and pulsed with recombinant human serum albumin(rHSA)as conDC(control DC),or pulsed with HBsAg andHBcAg in combination as scDC.Phenotypic patterns of MoDCs were characterized by flow cytometry,and the levels of cytokines releasedby MoDCs were analyzed by ELISA,and frequencies of IFN-γ-producing antigen-specific autologous T cells were measured by Elispotassay.HBV-specific CD8 T cells proliferation was determined by pentamer staining.Results 1.The levels of MHC and costimulatorymolecules expressed on scDC were significantly higher than those on immature MoDC(imaDC)in two groups,and the levels of MHC andcostimulatory molecules expressed on imaDC,conDC and scDC in HBsAg+,anti-HBe+,anti-HBc+patients(1-4-5 positive group)were significantly higher than those in HBsAg+,anti-HBc+patients(1-5 positive group);2.The levels of IL-12 and IL-10 produced byscDC were higher than those produced by imaDC and conDC in both groups,and the levels of IL-12 produced by imaDC,conDC and scDCin 1-4-5 positive group were higher than those in 1-5 positive group.3.The frequencies of IFN-γ-producing T cells induced by scDC werehigher than those by conDC in 1-4-5 positive group.4.scDCs from 4 cases of HLA-A2+patients in 1-4-5 positive group could induceautologous T cells to generate HBVcore18-27-specific CD8 T cells.Condusions HBsAg and HBcAg pulse in combination couldsubstantially reverse the impaired function of MoDCs in HBv-associated HCC patients,and boost MoDC to induce HBV-specific T cellsresponse,especially in HBsAg+,anti-HBe+ and anti-HBe+ patients.

BACKGROUND: Tissue engineering plays an important role in treating rotator cuff injury. Promoting the healing of injured rotator cuff and preventing adhesion by regulating growth factor expression are main functions. OBJECTIVE:To compare the effects of corticosteroids and hyaluronic acid on the expressions of epidermal growth factor (EGF),platelet-derived growth factor (PDGF),transforming growth factor ? (TGF-?) and basic fibroblast growth factor (bFGF) in injured rotator cuff. DESIGN,TIME AND SETTING: The randomized controlled animal experiment was performed at the Animal Experimental Center,School of Medicine,Shanghai Jiao Tong University from July to September 2007. MATERIALS: Totally thirty-six Sprague-Dawley (SD) rats were randomly assigned into four groups: normal group (n=6),rotator cuff injury group (n=6),hyaluronic acid group (n=12) and corticosteroids group (n=12). METHODS: Full-thickness defects across 50% of the total width (5 mm) of the bilateral infraspinatus tendon were excised. Models of rotator cuff injury were created at the synovium. 0.05 mL hyaluronic acid was injected into the subacromial bursa mucosa in the hyaluronic acid group,whereas 0.05 mL corticosteroids in the corticosteroids group. MAIN OUTCOME MEASURES: At three and six weeks after injury,the infraspinatus were harvested to detect EGF,PDGF,TGF-? and BFGF by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: By using corticosteroids treatment,the expression of EGF remained greater at the six weeks than twofold at the three weeks; the expression of EGF after hyaluronic acid treatment greatly decreased at six weeks (P

Objective To observe the efficacy of Complex Oral Motor Scoring (COMS) and diadochokinetic rate (DR) on evaluation of oral motor dysfunction and speech disorders in children with cerebral palsy. Methods 107 children with cerebral palsy were tested with Chinese-version Articulation Test, Simple Oral Motor Scoring (SOMS), COMS and DR. The correlation among SOMS, COMS and DR was analysesd. Results 85 children were abnormal in SOMS and 94 in COMS. Oral dyskinesia was found in all the children with spastic quadriplegia, dyskinetic, ataxia and mixed type of cerebral palsy, and less in the type of spastic diplegia and hemiplegia. DR was the least in spastic quadriplegia, dyskinetic, mixed type of cerebral palsy, more in the type of ataxia and spastic diplegia, and the most in hemiplegia. The coefficient of correlation among the SOMS, COMS, the longest pronunciation and DR were more than 0.8 (P<0.01). Conclusion The incidence and severity of oral dyskinesia and dysarthria are associated with the types of cerebral palsy. There is good correlation among SOMS, COMS, longest pronunciation and DR.

Objective To investigate the prevalence of malnutrition in human immunodeficiency virus ( HIV )‐infected children in China , and to explore and analyze the factors associated with malnutrition .Methods A cross‐sectional study was conducted by the antiretroviral treatment database of children .HIV‐infected children aged between 0 - 15 years old who initiated antiretroviral treatment were collected between January 1st , 2010 and December 31st , 2014 . Z‐score of height and weight were calculated by WHO Anthro (plus) software .Univariate and multivariate Logistic model analyses were performed to determine the factors associated with acute /chronic/mixed malnutrition .Results Baseline data of the 3 138 HIV‐infected children showed that 1 645 patients (52 .42% ) had malnutrition before antiretroviral treatment ,with acute ,chronic and mixed malnutrition of 8 .76% (275) ,39 .77% (1 248) and 3 .89% (122) ,respectively according to the type of malnutrition .Multivariate analysis showed that baseline CD4 + cell count < 200 cells/μL was the risk factor associated with acute malnutrition (aOR =2 .27 ,95% CI :1 .68 - 3 .06) ;rural settings (aOR = 1 .30 ,95% CI :1 .11 - 1 .53) ,baseline CD4 + cell count < 200 cells/μL (aOR = 1 .98 ,95% CI :1 .65 - 2 .38) ,baseline CD4 + cell count between 200 to 350 cells/μL (aOR = 1 .38 ,95% CI :1 .13 - 1 .69) and having AIDS‐related diseases (aOR = 1 .34 ,95%CI :1 .13 - 1 .59) were risk factors associated with chronic malnutrition ;and age of 11 - 15 years (aOR =2 .38 ,95% CI :1 .46 - 3 .88) ,baseline CD4 + cell count < 200 cells/μL (aOR = 4 .99 ,95% CI :3 .04 -8 .21) and having AIDS‐related diseases (aOR = 2 .45 ,95% CI :1 .65 - 3 .66) were risk factors associated with mixed malnutrition .Conclusions The prevalence of malnutrition in untreated HIV‐infected children remains high .All three types of malnutrition are associated with immunodeficiency .Early diagnosis and early treatment should be improved in HIV‐infected children through antiviral therapy to reduce the destruction of HIV to immune system .At the same time ,intensified monitoring of the nutritional status and nourishing undernourished children should be strengthened to reduce the prevalence of malnutrition .